Intro To Anti-Infectives

Front 1

Goals of Anit-Infectives?

Back 1

1. To gain access to target sites through absorpation and distribution through the blood steam.
2. To Destroy or Supress the growth of of infecting organisims so that normal host defences mechanisms can gain control of the infection.

Front 2

Bacteria

Back 2

Have a cell wall & reproduce by cell divsion

Front 3

Viruses

Back 3

No organized cellular structure; Live & Reproduce within living cells by using Host DNA & RNA (Parasitic Process)

Front 4

Fungi

Back 4

Yeast, Mold, & Spores whose structure resembles that of a human cell

Front 5

What is the course of disease dependent on?

Back 5

Microrganism
Virulence
Host Defences

Front 6

Factors that impair the Host

Back 6

1.Break in Skin and Mucous Membranes
2. Impaired Blood supply
3. Neutropenia and other blood disorders
4. Manlnutrition
5. Poor Personal hygiene
Supression of Immune System
Chronic Illness
6. Young or Old Age
exposure to Microbials

Front 7

Mechanism of Action
Inhibtion of cell wall synthesis

Back 7

Supresses Newly Forming & Growing Cells

Front 8

Mechanism of Action
Distributaion of Cell Membrane
Permeability

Back 8

Results in Leakage of folic & Amino Acids

Front 9

Mechanism of Action
Inhibition of Protein Synthesis

Back 9

Slows Cell growth and rate, allowing bodys immune system to oversome infection

Front 10

Mechanism of Action
Inhibtion of RNA & DNA Synthesis

Back 10

Impairs Genetic Inforamtion needed for replication

Front 11

Mechanism of Action
Interference with Cellular Metabolism

Back 11

Prevents Microbes from making folic acid essential for function

Front 12

Mechanism of Action
Inhibition of Viral Enzymes

Back 12

Inhibits enzymes that assist virus to attach to host cell.

Front 13

Criteria for Drug Selection

Back 13

1. Organism Causing the Infection
2. Site of Infection
3. Host defense Status
4.Pharmacokinetics &
Pharmacodynamics
5. Renal and Heptatic Function
6. Ability to Monitor Therapy
7. Pregnancy & Lactation

Front 14

How is the organisim that is causing the infection identified?

Back 14

Culture and Sensitivity Test

Front 15

When is a culture obtained?

Back 15

Before a Narrow Spectrum Anitbiotic is perscribed, but broad spectrum anitbitoics can be implemented up unitl test results come back from lab.

Front 16

Chief means of excretion for most anti-infectives

Back 16

The Renal and Heptatic Systems

Front 17

Who is responsible for monitoring therapeutic effects?

Back 17

YOU, the nurse!

Front 18

Broad Spectrum

Back 18

Used when the organisim has yet to be identified via the culture and sensitivity test. It also acts on a wide range of organisms.

Front 19

Narrow Spectrum

Back 19

Used when an Organism has been identified. Also, treat infections caused by a limited number of organisms.

Front 20

What is Emperic Therapy?

Back 20

Empiric therapy is a medical term referring to the initiation of treatment prior to determination of a firm diagnosis.

Front 21

What is a Loading Dose?

Back 21

If a drug takes a long time to reach therapeutic levels, then a higher dose (the loading dose) may be given initially before dropping down to a lower maintenance dose. Achieves rapid Max blood concentration

Front 22

Measures Serum concentration; time drawn varies with drug rout

Back 22

PEAK

Front 23

Obtained immediately before next dose of drug

Back 23

TROUGH

Front 24

What may cause anaphylactic shock?

Back 24

Pencillan

Front 25

What is a major problem with Ani-infectives?

Back 25

RESISTANCE
May be brought on naturally or may be acquired

Front 26

What happens if clients symptoms continue or worsen?

Back 26

Suspect Resistence

Front 27

How can a Nurse prevent an adverse reaction?

Back 27

1. Check for Hx of Allergies
2. Educate Patients what to look for
3. Observe response

Front 28

What are the symptoms of Anaphylactic Shock?

Back 28

Mild-rash, hives, itching
Major- Vascular Collapse, Laryngeal Spasm, Bronchospasm, and Cardiac Arrest

Front 29

How do you treat a mild adverse reaction to Anti-infectives?

Back 29

With anti-histamines

Front 30

How do you treat a severe Reaction to anti-infectives?

Back 30

With Epinephrine and Bronchodilators

Front 31

What builds up a resistance to organisims that seem to be unaffected by anit-infective Therapy?

Back 31

1. Aquired through improper dose, lenght of time between doses, & duration of therapy.
2. enzymes inactivate drug, cell wall changes restrict drug entry, or Alternative Metabolic Pathways develop.

Front 32

What is a super infection?

Back 32

it is a secondary infection apperaing during drug therapy for a primary one

Front 33

How does a super infection happen?

Back 33

The normal microbial flora are disturbed allowing porliferation of microbes that are usually supressed.

Front 34

What is the most common super infection?

Back 34

FUNGAL
ex: Yeast (Vaginia), oral mucosa (Candida Thrush), Resp. Tract, and GI Tract

Front 35

What is the usual way a super infection starts?

Back 35

Results from long term; broad spectrum therapy

Front 36

What is Pseudomembraneous Colitis?

Back 36

An overgrowth of toxin producing Clostridium Difficile (a.k.a C-Diff). Can erode lining of GI Tract, causing profuse watery diarrhea, Fever and Cramping

Front 37

If a client has C-diff, what the heck do you do?

Back 37

1. they need to be in Contact Isolation
2. Isolate that stool and WASH HANDS!

Front 38

How long does it take for c-diff to resolve?

Back 38

3-5 days when treated with Vancomycin & Methronidazole (Flagyl)

Front 39

How is C-diff caused?

Back 39

can be caused by High dose or extended use of drug theapy.

Front 40

How is toxicity prevented?

Back 40

evaluate organ function prior to and during drug therapy. Also assess blood concentration levles.

Front 41

What anti-infective can affect bone marrow thus causing anemia?

Back 41

Chloramycetin

Front 42

What anit-infective can cause a decrease in WBC leading to Leukopenia?

Back 42

Sulfonmides

Front 43

Which anti-infective can increase bleeding with a blood thinner (Warfin/Comadin?

Back 43

PCN

Front 44

Which drug can cause excessive decrease in blood sugar with oral hypoglycemics?

Back 44

Sulfonamides

Front 45

Which anti-infective can cause an increase in serum level of antiarrhythmics & bronchodilators?

Back 45

Erthromycin

Front 46

Nursing Implications

Back 46

1. Obtain Allergy HX
2. Note Allergies on arm band, med record, & physician order sheet
3. Asses client before and during drug therapy
4. Monitor labs (Like liver and Kydney function)
5. Support client's natural immune system
6. Hand wash to prevent the spread of Microbials.

Front 47

Client Education

Back 47

1. take drug with medical supervision
2. Take exactly as directed
3. don't take left over drugs
4. don;t stop takinf drugs, just because they feel better
5. Notify Doc if side effect occure or sypmtoms persist.
6. Always wear an allergy band.

Front 48

What promotes repeated remission & exacerbations & Drug Resistance?

Back 48

It is the result of too small of doses taken for too short a time